dian57

dian57

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All Content by dian57

  1. Our facility is trying to develop a system for adequate MDS documentation. We have tried posting diagnosis driven cheat sheets (document on at least 2 of these items/shift) posted on the chart and a...
  2. High fall risk

    Risk for falls with injury will be reduced. Then list all the interventions you have in place to reduce the
  3. A 20-something woman and her mother came in looking very, very concerned. Problem? Daughter swallowed her gum. Therapeutic wait? You
  4. Holy cow - what are people thinking

    First, I am NOT saying the facility was not at fault in this case. But a word of caution must be spoken. We (the public, not just nurses) really need to keep in mind that this story was printed in the...
  5. fall interventions

    Since we initiated the supervised activity program the only falls we've had are rolls out of bed (onto bedside mattresses) and late night wandering out into the bathroom (although staff was alerted by...
  6. fall interventions

    We have the same issue (doesn't everyone in LTC?). We instituted 1/2 hour activity "bursts," as we've determined our population doesn't have much more than 30 minutes worth of attention span to devote...
  7. Scenario:What would you do?

    First, let me apologize if I repeat something already posted. I have not read all the previous posts. Palliative Care is a relatively new concept in our country; a country that is accustomed to fixing...
  8. As far as visitors and excessive use of callbells and visits to the nurses station with questions: I've often considered posting a sign that says: If you have run out of conversation with your loved...
  9. funniest thing you saw a nurse do.......

    I remember another student nurse experience and hope this doesn't offend anyone here. I was all of 19, a student LPN. My instructor, a student friend and I stood at the bedside of a 30ish man as I...
  10. Who places your PICC lines?

    Recent policy change here: PICCs are placed by surgeons in the OR of our community hospital. Can be removed only by IV certified RN at
  11. Funny patient names by nurses

    There was a little boy down the street and his parents wanted to name him Harley with Davidson as his middle name. They settled on Dallas. The little brother was Austin. Were they from Texas? Nope,...
  12. pearls of wisdom

    Always do the right thing. This means different things to different people. I always take it as Let your conscience be your moral
  13. What is the hardest nursing class?

    I had the hardest time with Maternal/Child nursing. And, like HarleyGirl, I can tell you why--I had absolutely NO INTEREST in Maternal/Child nursing. As one of the oldest students in the class, I got...
  14. Anyone Else Catching Flack for Going Back to School?

    I was an LPN for 17 years. I had this one nutty RN supervisor for awhile who relieved an even nuttier day supervisor on my unit (LTC). One evening the other LPN on the unit looked at me and said,...
  15. JBudd reminded me of a silly thing *I* did on the job recently. The DOH was in for the annual survey. I was 6 weeks into my new position as DON and feeling more than a little stressed with their...
  16. Discharge orders you'd LIKE to write!!!

    My guess would be that was on a very, very, very bad
  17. Discharge orders you'd LIKE to write!!!

    Want to read a hilarious essay from an ER nurse? Check this Best of Craigslist entry out. It had me howling!
  18. Discharge Order Help

    That's where the Medical Director comes in. It's up to the M.D. to rein in the rouge docs who think their time is worth more than anyone elses. If a doctor ever hung up on one of my nurses, the next...
  19. Discharge Order Help

    I think a "Continue Home Meds" order can be dangerous and leave the doc open to problems with misunderstandings, especially in my geriatric setting. Maybe it's okay for younger hospital patients with...
  20. any facilty overdocument???HOW FRUSTRATING

    I agree with Bird2. As a floor nurse, duplicate documentation made me crazy. As a Clinical Care Coordinator I recognized the danger of duplication--the more places the same information was written,...
  21. setting limits in long-term care

    The only time I've ever used controlled isolation with a resident was a lady with a stroke that left her with incessant chanting. With assessment and observation, we saw that her chanting escalated to...
  22. Call-off policy

    Working in a nursing home is different than working in a supermarket. When you're short-staffed, the cereal boxes don't know any better. Our business is human life and unfortunately, mandatory...
  23. Bowel Protocol

    On admission, we SUGGEST to the doc our normal bowel protocol: 2 days no BM--warm prune juice 3 days no BM--30 ml MOM no BM in the following 16 hours--Fleet enema If we use MOM twice in a month, we...
  24. Geriatric nurses, can you help?

    This is probably more than you're asking for but here goes . . . As with most problems, start at the beginning. WHY is this gentleman not eating? Look at his diagnoses and labs and see if they...
  25. No Overtime! Period!!

    I sit at those budget meetings and believe me, they aren't pretty. When the directive comes down NO OVERTIME, what is actually meant is, No Unecessary Overtime. On review of my staff time sheets, the...